Allied Chiropractic Center of Eagan PA.

Organization Active NPI Chiropractor · Bloomington, MN

NPI 1851464036 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1851464036
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
2493 (MN)
Legal business name
ALLIED CHIROPRACTIC CENTER OF EAGAN PA.
Practice address
3916 W 113TH St
Bloomington, MN 55437-3503
Phone
(612) 709-3104
Fax
(952) 884-0852
NPI assigned
Nov 16, 2006
Organization subpart
No

Authorized official

Name
Dr. Mark Charles Gustafson, D.C. NPI 1306919931
Title
Ceo,Chiropractor
Phone
(612) 709-3104

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 2493 MN Yes

Addresses

Primary practice location

3916 W 113TH St
Bloomington, MN 55437-3503

Mailing address

3916 W 113TH St
Bloomington, MN 55437-3503
Phone (612) 709-3104

Other providers in Bloomington, MN

All providers in Bloomington, MN · Chiropractor in Minnesota

Sources for this page

Verify at the official NPI Registry.